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General NPI Number Information
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NPI Number | 1295840379
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Entity Type | Individual
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Provider Name | THERESA MARIE REDLING D.O.
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Gender | Female
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Dates
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Enumeration Date | 08/20/2006
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Last Update Date | 04/09/2024
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Provider Practice Location Address
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Address Line | 200 S ORANGE AVE STE 112
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City | LIVINGSTON
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State | NJ
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Zip | 07039-5817
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Country | US
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Telephone | 973-322-7636
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Fax | 973-322-7673
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Provider Business Mailing Address
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Address Line | 200 S ORANGE AVE STE 112
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City | LIVINGSTON
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State | NJ
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Zip | 07039-5817
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Country | US
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Telephone | 973-322-7636
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Fax | 973-322-7673
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MB53001
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | MB53001
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License Number State | NJ
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